vCJD death linked to blood transfusion

A British man has died from variant CJD after receiving a blood transfusion seven years earlier from a donor who also later died from the disease. The UK secretary of state for health announced the case in an emergency statement to parliament on Wednesday.

The case may be the first in the world where the human form of BSE – mad cow disease – has been transmitted via a blood transfusion. But John Reid told the House of Commons&colon; “This is a possibility not a proven causal connection.”

Both individuals might have acquired the devastating illness separately by eating BSE-infected meat, he says, but “the possibility of this being transfusion-related cannot be discounted”.

The recipient of the blood transfusion had received the blood in 1996 from a donor with no sign of vCJD. But the donor developed VCJD symptoms and died in 1999. The recipient became ill six and a half years after the transfusion and died in autumn 2003.

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Fifteen other people in the UK are now known to have received blood from donors who subsequently developed vCJD, according to the UK National Blood Service. These individuals are now being contacted and will be offered advice from expert counsellors.

No test

“There is as yet no blood test for vCJD, or for that matter BSE, let alone one that could detect the disease years before symptoms develop,” said Reid. “So, there is no way yet of screening blood donations for the presence of the CJD group of diseases.”

However, he noted that the UK Government had put measures in place from 1997 to try to reduce the risk of person-to-person transmission of vCJD via blood transfusions. First, blood stocks from donors who later developed vCJD were destroyed.

In July 1998, a programme to remove the white blood cells from blood destined for transfusion began. White blood cells were considered to be a possible source of infection. Finally, from the end of 1999, all plasma used for blood products has been sourced from the US rather than the UK.

However, 15 people have received blood from donors who subsequently developed vCJD. Five of these received the “leuco-depleted” blood – stripped of its white blood cells. But “many more patients of course will have received plasma products before plasma was sourced from the US,” cautioned Reid.

Uncertain future

The ultimate extent of the UK epidemic is currently estimated to be between a few hundred and 7000. So far 143 people had died of the disease.

“It is premature to conclude the epidemic has peaked” warns Reid, because the incubation period of vCJD is uncertain.

The link between the recent death of the blood recipient and the donor was first reported to Reid’s office on 9 December, while a diagnosis of vCJD for the recipient was still being confirmed.

Confirmation came on Friday 12 December and Reid was briefed by the UK’s chief medical officer Liam Donaldson on Monday and Tuesday. The announcement was made at the “earliest opportunity”, says Reid.